| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,756 |
2,745 |
$203K |
| 92250 |
|
2,808 |
2,795 |
$129K |
| 92083 |
|
1,968 |
1,957 |
$95K |
| 92285 |
|
2,206 |
2,192 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,396 |
1,414 |
$43K |
| 92060 |
|
873 |
873 |
$32K |
| V2020 |
Frames, purchases |
1,794 |
1,766 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
356 |
356 |
$20K |
| 92286 |
|
196 |
196 |
$16K |
| 92133 |
|
243 |
243 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
137 |
134 |
$6K |
| 92015 |
Determination of refractive state |
457 |
457 |
$5K |
| 92020 |
|
38 |
38 |
$570.38 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
24 |
24 |
$327.08 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
227 |
135 |
$304.00 |